Organization
FOUNDATION FOR SUCCESSFUL LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA HARRIS (CEO)
(719) 227-3939
Entity
Organization
Contact information
Practice address
11479 PINE DR, STE 4, PARKER, CO 80134-7308
(719) 216-6482
Mailing address
11479 PINE DR, PARKER, CO 80134-7308
(719) 216-6482
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
04T233
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39852571
—
CO
Enumeration date
10/11/2016
Last updated
10/20/2016
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